In SC, prostate cancer much worse for Black men. Telling that story could save lives.

By Tom Corwin, writer,

Aug 29, 2022

As a prostate cancer survivor and a Black man in South Carolina, Lee H. Moultrie of North Charleston said he can’t be silent about it.The news he and other advocates have to share is not good: Black men in the Palmetto State die from the cancer at more than twice the rate of Whites, one of the worst cancer disparities in the country.

“I don’t think the message is getting out as much as we would like it to be,” said Moultrie, 65. “It’s not in the mainstream discussion.”

That is the mission of the Prostate Health Education Network, which recently held an online rally in South Carolina to encourage more survivors to share their message with Black men and encourage them to seek testing. The group has also been airing ads and public service announcements on radio across the state.

“It’s very important to be transparent, to share our stories, to let men know we don’t need to be afraid of this disease,” said Dr. Larry Ferguson of Charleston, a dentist and prostate cancer survivor.

The news they have to share is grim: the incidence of prostate cancer in Black men in South Carolina is 73 percent higher than for Whites, and the death rate is 2.4 times higher, said Dr. Keith Crawford, director of clinical trials and patient education for the advocacy network.

The disparity varies across the state.

The incidence of prostate cancer for Black men in Charleston and Columbia is about 50 percent higher than for Whites, but it is 87 percent higher in Greenville, Crawford said.

The death rate is 62 percent higher in Charleston but 90 percent higher in Columbia and 240 percent higher in Greenville. Knowing that variation, “we can better address the problem,” he said.

The death rate in his hometown got the attention of Johnny Payne of Greenville, a survivor and advocate with the Upstate Prostate Cancer Alliance.

“That’s a really disturbing number,” he said.

Part of the problem is silence, said Mr. Thomas Farrington, founder and president of the advocacy network and a 22-year survivor.

The group had for years promoted Father’s Day events in Black churches to encourage more men to learn about their risk and offer a special prayer for survivors. One or two men would usually come forward, but Farrington said he was often approached privately by other men afterward who were survivors, but who were not sharing it.

“Men in the church sitting next to each other did not know they were both survivors”, he said.

The benefits of hearing those stories can be immediate, said Dr. Byron Benton, senior pastor of Mount Moriah Missionary Baptists Church. Soon after his father, a survivor, and Ferguson spoke at a special service the church organized one of the congregants told him that he got screened, was diagnosed with prostate cancer but “they caught it early,” Benton said. Those stories “literally saved a life,” he said.

Early detection makes a difference, from a 90 percent survival rate at five years versus late-stage disease with a 31 percent survival.

By pushing early detection, “we will make a major impact on reducing disparity and saving lives,” Farrington said.

Speaking out

Still, men are reluctant to bring it up, and the group is out to change that. When he was diagnosed in December 2020, Ferguson immediately called his son and daughters “because I wanted the men in my life to know it is very important for you to stay on top of your PSA” or prostate-specific antigen test, a blood test that looks for proteins that can signal an increase in cancerous cells, he said.

The test itself is controversial. After being approved as a screening test in the mid-’90s, evidence showed that the elevated levels found in the test could not only signal cancer but also many benign conditions. Beginning around 2008 many medical organizations began to back away from recommending it as a routine screening.

The U.S. Preventive Services Task Force, whose recommendations are often followed by Medicare and large insurance companies, recommends that for men ages 55 to 69 it should be an individual choice discussed with a health care provider, because the test offers a small potential benefit but also the risk of harm, including false-positives that lead to other tests or procedures such as biopsies.

Black men have the highest risk of prostate cancer and the potential benefit from the test for them is much higher, advocates said. Research showed that beginning the test for Black men at age 45, for instance, would reduce their mortality by 26-29 percent, Crawford said. The discussion should really begin for them at age 40, he said.

Those discussions should go beyond prostate cancer to men’s health in general, said Moultrie, who has been advocating for greater cancer screening and awareness long before he himself was diagnosed with prostate cancer in 2015.

After conversations with his doctor, he decided on “watchful waiting,” the practice of monitoring the slow-growing cancer instead of opting for immediate treatment, an option Moultrie thinks is not talked about enough.

After six years, his PSA shot up and in November his doctor recommended treatment. Moultrie completed proton therapy, a kind of focused radiation therapy, in February and is monitoring his PSA for now. But he has also gotten more serious about improving his health overall, committing to exercise and a more rigorous diet while getting his diabetes under control. That’s a message men don’t hear enough as well.

“Guys are passive about their health because nobody has told them ‘It’s your responsibility,’” Moultrie said. Part of that is getting the PSA and also a digital rectal exam that can also help detect prostate cancer.

Just by getting them, “you are reassured one way or the other,” Moultrie said. And it might save your life.

Photo Credits: Lee H. Moultrie, a prostate cancer survivor, works out at the gym Aug. 22, 2022. Moultrie takes care of himself by going to the gym and watching his weight and diet. Brad Nettles / Staff


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